Growth industry: UVA, MJH ready for the morbidly obese

news-michelle-herefordAt UVA's new Transitional Care Hospital, Michelle Hereford stands under a ceiling-mounted lift that can transport obese patients from bed to bathroom.

UVA's newest hospital building acknowledges a cruel fact of life: Americans are getting fatter–- much fatter. At the swanky new Ivy Road facility designed for long-term acute care, 11 of the 40 rooms can handle patients weighing up to 1,000 pounds, thanks to heavy-duty beds and overhead electric lifts.

"It is very innovative," says Michelle Hereford, associate chief at UVA's new Transitional Care Hospital. "It decreases injuries and helps with patients being mobile."

On a reporter's recent tour of one of the so-called "bariatric" patient rooms, it's evident that the room is bigger than usual. So are the beds, which are reinforced and capable of holding patients who might qualify for the record books.

Overhead, a monorail-like ribbon of steel snakes across the ceiling. That's the track for the  Pinnacle brand overhead lift, an electric winch-equipped device that can lift a half-ton patient out of bed and all the way to the bathroom.

Bariatric medicine is booming locally. An estimated 20 to 24 percent of adults in Virginia are obese, according to the Martha Jefferson Bariatric Center, whose website, when one is searching the term "obesity health risk," currently pops up first under sponsored results.

"We already offer bariatric services," says Martha Jefferson spokeswoman Jenn McDaniel. "At the new hospital, all of our rooms are designed to accommodate bariatric patients."

Slated to open next year at Peter Jefferson Place, Martha Jeff's new facility will feature extra-wide doors on all bathrooms and in all patient rooms, and all the beds will hold up to 500 pounds.

"Thousand-pound patients are few and far between for us," explains McDaniel. "We will rent those beds if we need them on a case-by-case basis."

And unlike UVA's Transitional Care Hospital, Martha Jeff opted not to install overhead lifts.

"Our team looked at those and found that most patients don't fall between the bed and bathroom," says McDaniel. "They fall in the bathroom or in the hall. We'll have portable lifts if they need help getting onto machines like MRIs, or between the bed and bathroom if needed."

The two Charlottesville medical centers are not alone. Large patients appear to be fueling a national growth industry.

"Look at the data," says McDaniel. "Overall, Americans are getting larger."

A recent Center for Disease Control Foundation study published in the July 27 issue of Health Affairs pegs the cost of obesity health care in the United States as high as $147 billion, double what it was a decade ago, with half the costs covered by the federal government through Medicare and Medicaid.

James Zervios, spokesman for the Obesity Action Coalition, thinks focusing on what the taxpayer pays is unfair.

"Someone who smokes and gets lung cancer, we don't say my tax dollars shouldn't pay for care," he says. "Someone who sunbathes and gets skin cancer, we don't say we shouldn't pay."

With 93 million Americans affected by obesity, bariatric facilities at hospitals are long overdue, says Zervios, because the care of some large patients is hampered by outmoded equipment.

"We've experienced it a lot with hospitals who can't handle someone of size," he explains, noting that ambulances also need special equipment to properly transport extremely obese patients.

The injury risks of obesity aren't limited to obese people. Nursing aides, orderlies, and attendants reported 24,340 back injuries in 2007, the second highest of all occupations, while registered nurses ranked seventh with 8,580 cases, according to Katherine Cox at the American Federation of State, County and Municipal Employees.

While patient weight wasn't tracked in those numbers, Cox says she wouldn't be surprised if injury rates climb with the weight of the patient, and she points to legislation sponsored by Minnesota Senator Al Franken, the Safe Patient Handling Bill, that would mandate patient lift equipment.

"It's a huge issue we've been working on for a number of years," says Cox. "We'd say back injuries among health care workers is epidemic."

Cox praises new facilities like UVA's and Martha Jefferson's for providing infrastructure to reduce such injuries.

"The problem for some of the older hospitals is that it's not doable," explains Cox. "Think of the weight. You don't want to pull down ceiling tiles."

At UVA's Transitional Care Hospital, the innovations don't stop with the heavy lifting. The facility is primarily designed for weaning patients off ventilators at a cost far cheaper than an ICU. The rooms have their own bedside monitors, in-wall oxygen supplies, and some rooms are pre-plumbed for dialysis.

"It's very innovative," Hereford reiterates. "And," she adds, "patients don't have to be obese to use this equipment."


The food does not jump from the macdonalds bag to the mouth, the eager hand moves it there.

Last time I was in MJH, I was shocked at how obese some of the staff were. If hospital employees can't maintain a health weight, then doesn't that say something about the hospital?

The need for such a facility is gross and must seem truly bizarre to people in the rest of the world.

take away their "The View" watching privileges and fat people will be forced to lose weight. fat people should pay more for health care, insurance and they should have consequences for being fat.
fat people are a total drain on American society.

Anybody know when this new UVA LTAC hospital will be up and running? Is it up and running already? Sorry if I missed that in the article.

Free advice: Don't eat food, and you will lose weight.

Next red-hot topic (while the rest of us starve).

Just happened back to The Hook again..... Yes, raping the insurance Co's and bill-payors is a huge problem.
"Raping" was a poor word choice. Doctors and hospital systems identify a huge revenue source, like the climbing number of chronic lung sufferers, and adopt "treatment" protocols and fictitious goals to exploit these populations. Fair enough?
No. Left over, scarce medical resources to treat and prevent the maladies with HIGH probability of good outcomes are poorly implemented and poorly funded. And the young, without the power to exert healthy choices, become the next generation of cash cows to this system.
Oh yeah, and the nurses are there to rubber-stamp their employers' priorities.
As for your take on the benefits of segregating these chronic lung patients...yes, they're going to live longer, in and out of this facility, just like the payors require. Not worth the downsides.
Oh, to hell with this.

Antrim clearly doesn't know his/her butt from a hole in the ground. Plenty of non-chronic (non-smoking and non-obesity related) illnesses require temporary intubation/ventilator assistance. Chris is ABSOLUTELY correct that it is cheaper all around to wean those patients off of a ventilator in a setting other than a hospital's ICU.

The biggest problem with the internet is knuckleheads who do not know what they are talking about behaving as if they do know what they are talking about.

"I figure when those Taliban fellas see a video of a morbidly obese person riding around on one of those electric carts in the aisles of the Food Lion they’re laughing their asses off."

No, they would not be laughing. They wouldn't be able to comprehend what they are looking at.

I think food fills a void for some people just like drugs and alcohol do for others. So instead of drinking a six-pack, Betty-Sue eats a whole cake, or a bucket of chicken. One big difference though, I guess the eater isn't impaired.

Chris - while I am annoyed at how we as a society seem to continue encouraging the unhealthy car commuter endpoint destination lifestyle, you are a perfect example of how we should be careful of deamonzing these folks. I don't know if you are overweight or not, but custic fibrosis can of course radically affect how much exercise a person gets, perhaps leading to weight gain. CF also is hardly a case of problems due to physical abuse.

Such individuals as yourself is what we have health care for, and why I can consider the idea of a flat health insurance rate, for example. Yes, you might cost more to treat than myself, but you didn't ask for what you have.

Good news, Fluvanna!

Sometimes overweight people have better health than those whoa re thin. Genes aren't very fair. But we definitely need to do something about the morbidly obese.

Developing our cities and existence so that they are more oriented towards pedestrian activity and less towards the big box store for anything would be a big start. Having large places to buy items in bulk, or to buy tings like appliances, which you don't need that often is understandable. But people should be able to get a lot of their items fresh on a routine basis without having to drive all the time.

Every neighborhood should have a selection of small businesses within a few blocks to meet those needs.

Of course, that's ant- American anti-county, I know, but that's really the only way to change the trend.

There ARE fat people in other countries, certainly in Europe, but they at least tend to get more exercise.

@ Michael 2 - No, it doesn't say anything about the hospital. Yes, some of the staff is obese; and, some of them are phenomenal clinicians.

@ Antrim - Also, no. I think I gather from your post that you think once someone is on a ventilator that we should conclude that something will kill them and end it quickly? Or is it that we should never put someone on a ventilator in the first place? Or do you simply have a problem with weaning someone off of a ventilator? I'm confused.

Being able to get someone who is on a ventilator out of the ICU, away from patients who are more sick and potentially more able to spread an infection is a great idea. Being able to have a team who spends all day weaning people off a ventilator will reduce problems. Patients will do better, it will cost is that not something we should do?

Lastly, "raping the insurance co.'s?" You feel like this is a serious problem?

Great! Keep 'em alive longer, so they can drain our tax dollars. I was at Watercountry the other day, and could not believe the amount of young people that were morbidly obese. They were all stuffing their faces with food, and soda everytime I saw them. This country is a laughingstock to the rest of the world. When, I was growing up. Fat people were mocked and laughed at, it was cruel but it worked. You didn't see as many.

I figure when those Taliban fellas see a video of a morbidly obese person riding around on one of those electric carts in the aisles of the Food Lion they're laughing their asses off.

Joe Pantop - MMmmMM....I don't know that laughing at fat people got the results you think. People still laugh at fat people, just look at this thread. I think I was the last of a generation of kids that routinely played outside for fun. We went bike riding, roller skating, ice-skating, etc. Right there, you set a life pattern, and degree of activity.

Now the youth spend a lot of time behind the computer, as we are right now, being sedentary. Sure, many play sports, but organized sports in their boxed in time. They don't just get out and run.

Add to all this the super size model, with the tons of sugar snacks, poorly planned school meals, and you get lifelong health problems.

I get to fly first class a lot, and one of the funniest things I noticed's always the white 50 something business guys in their business suits who sport guts and are sucking away at the booze aka sugar. Everybody else is of a healthier weight if not downright fit. Wanna bet those guys are the first to rant against a national healthcare system and crow how they pay for everything and shouldn't have to pay taxes????

We all pay for this, through our health care premiums, so the fantasy that somehow we benefit by denying health education to overweight folks by a privatized system is just bonkers.

Enough care really gets me going.

@ Dahmius:

Yeah, if there actually even was such a thing as "the Taliban." Which there isn't. At least, not in the way the media tells us.

But that's a topic for another story.

Back to the fat people......

Fat people should pay much much more for health insurance. They should pay more for car insurance (They get in more accidents). They should also pay more for medicare/medicaid but less for social security (they don't live as long).

"primarily designed for weaning patients off ventilators..."

Right. Primarily designed for raping the insurance co's, Medicare, and taxpayers, as the patients and families wait for inevitable infections, mishaps, and progressive deterioration.
It's medical fraud.

Nice. The solution is not to lose weight. This is America! The solution is to put a winch in the ceiling to get yer big butt to da baffroom.

Antrim...I'm one of the "chronic lung sufferers." I have cystic fibrosis. I spent a fair bit of last summer in a couple of different ICUs at UVA. Got weaned off of a vent twice (the second time really quickly). Several months later I got a lung transplant and now I'm a productive member of society again. The goals weren't fictitious.

There is fraud in our medical system. It clogs things up and prevents many people getting treatment they need. But let's not sweep all medical workers away with the same broom. The vast, vast majority of nurses that I know work their tails off to try to help their patients get better. They're not rubber stamping anything.

The bottom line is you're right so far as it goes about there being fraud and misuse of medical resources on some levels. But in general, I disagree with most of your conclusions.